The seroprevalence of CMV among Japanese blood donors of child-bearing age has not changed over the past 15 years. Latent CMV becomes reactivated more frequently among elderly donors than among younger donors. A proportion of them have free CMV DNA in their plasma fraction, which could not be diminished by leukoreduction. The risk of transfusion-transmitted CMV infection in blood with plasma CMV DNA should be determined.

The infectivity of HEV-contaminated components was 50%. Immunosuppression likely causes the moderate illness of TT-HEV, but it may lead to the establishment of chronic sequelae. Transfusion recipients, a population that is variably immunosuppressed, are more vulnerable to chronic liver injury as a result of TT-HEV than the general population is as a result of food-borne infection.

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BACKGROUND: Cytomegalovirus (CMV) transmission to very-low-birth-weight infants (VLBWIs) sometimes induces serious clinical symptoms. Although breast milk is considered a major source of transmission, transfusion-transmitted CMV (TT-CMV) infection is often suspected when CMV disease develops after transfusion. Thus, it is clinically important to distinguish between transfusion-transmitted and breast milktransmitted CMV infections. STUDY DESIGN AND METHODS: Study A: The incidence of acquired CMV transmission was prospectively investigated in 65 VLBWIs. Study B: To determine the transmission routes in 18 TT-CMVsuspected VLBWIs who had been reported in our hemovigilance system, we performed polymerase chain reaction for CMV DNA in fed breast milk and/or repository blood samples related to transfused leukoreduced blood products. Furthermore, we evaluated the identity of CMV strains in patients' urine/blood samples and fed breast milk by sequence analyses of variable CMV genes UL139 and UL146.RESULTS: Study A: Acquired CMV infection was found in 4 of 65 VLBWIs (6.2%). Study B: CMV DNA was detected in fed breast milk for 12 of 14 TT-CMVsuspected cases, for which breast milk was available. Furthermore, CMV DNA sequence-matching rates between fed breast milk and patients' urine/blood for both UL139 and UL146 genes were 100% or nearly 100% in 11 patients. In contrast, repository blood samples for 11 of 14 patients were CMV DNA negative.CONCLUSION: CMV is principally transmitted through breast milk in VLBWIs. The risk of TT-CMV seems to be extremely low when using leukoreduced blood products. Sequence analyses of the variable CMV genes are useful for evaluating CMV transmission routes. ABBREVIATIONS: BM-CMV = breast milk-transmitted CMV; CMV = cytomegalovirus; JRCS = Japanese Red Cross Society; LOD = limit of detection; PCR = polymerase chain reaction; TT-CMV = transfusiontransmitted CMV; VLBWI = very-low-birth-weight infantFrom the * The number of tested repository blood samples is the same as the number of transfused blood products. † Homology (the repository blood sample vs. patient) is 64.6% for the UL139 gene and 68.6% for the UL146 gene. 16 ‡ CMV DNA was detected in the testing conducted at the hospital. § Homology (the repository blood sample vs. patient) is 89.3% for the UL139 gene and 78.1% for the UL146 gene. FFP = fresh-frozen plasma; NT = not tested; PC = platelet concentrate; PCR = polymerase chain reaction; RBC = red blood cell. TRANSFUSION Volume 58, December 2018FURUI ET AL.

Collected samples were tested for T. cruzi antibodies using both an enzymelinked immunosorbent assay and a chemiluminescent immunoassay. Samples that tested positive in both assays were additionally tested by polymerase chain reaction, and look-back investigation was conducted when necessary. RESULTS:Of 18,484 samples obtained from 18,076 atrisk donors, 3 (1:6,025, 0.017%) donors showed seroreactivity by enzyme-linked immunosorbent assay and chemiluminescent immunoassay. All antibodypositive donors were born in Latin America. One of them also was positive for T. cruzi DNA. Eleven previous donations from this donor were subjected to look-back investigation, and five recipients were tested. All five recipients tested negative for T. cruzi antibodies.CONCLUSION: Seroprevalence of T. cruzi was 0.017% among at-risk donors in Japan. Transfusion-transmitted infection of Chagas disease has not been confirmed to date. Screening for T. cruzi antibodies by targeting atrisk donors is an appropriate strategy for ensuring blood safety in Japan. ABBREVIATIONS: CI = confidence interval; CLIA = chemiluminescent immunoassay; ELISA = enzyme-linked immunosorbent assay; ESA = enzyme strip assay; ICT = immunochromatographic assay; IFA = immunofluorescence assay; JCRS = Japanese Red Cross Society; PC = platelet concentrate; TTI = transfusion-transmitted infection; WHO = World Health Organization.From the